title: Family system dynamics and type 1 diabetic glycemic variability: a vector-auto-regressive model.
abstract: Statistical approaches rooted in econometric methodology, so far foreign to the psychiatric and psychological realms have provided exciting and substantial new insights into complex mind-body interactions over time and individuals. Over 120 days, this structured diary study explored the mutual interactions of emotions within a classic 3-person family system with its Type 1 diabetic adolescent's daily blood glucose variability. Glycemic variability was measured through daily standard deviations of blood glucose determinations (at least 3 per day). Emotions were captured individually utilizing the self-assessment manikin on affective valence (negative-positive), activation (calm-excited), and control (dominated-dominant). Auto- and cross-correlating the stationary absolute (level) values of the mutually interacting parallel time series data sets through vector autoregression (VAR, grounded in econometric theory) allowed for the formulation of 2 concordant models. Applying Cholesky Impulse Response Analysis at a 95% confidence interval, we provided evidence for an adolescent being happy, calm, and in control to exhibit less glycemic variability and hence diabetic derailment. A nondominating mother and a happy father seemed to also reduce glycemic variability. Random shocks increasing glycemic variability affected only the adolescent and her father: In 1 model, the male parent felt in charge; in the other, he calmed down while his daughter turned sad. All reactions to external shocks lasted for less than 4 full days. Extant literature on affect and glycemic variability in Type 1 diabetic adolescents as well as challenges arising from introducing econometric theory to the field were discussed.
authors.affiliation: Zentrum für Kinderheilkunde, Psychoanalytische Familienpsychosomatik, Justus-Liebig-University, Gießen, Germany. Moritz.Guenther@med.uni-giessen.de
authors.forename: Moritz Philipp
authors.initials: MP
authors.lastname: Günther
authors.forename: Peter
authors.initials: P
authors.lastname: Winker
authors.forename: Claudia
authors.initials: C
authors.lastname: Böttcher
authors.forename: Burkhard
authors.initials: B
authors.lastname: Brosig
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005196:Family Therapy; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008297:Male; D017059:Models, Econometric; D010332:Paternal Behavior / Q000523:psychology
chemical_list: D001786:Blood Glucose